| NPI | 1649677717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIKA TYSZKOWSKI President 773-736-6610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025140) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019025140) |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2014-12-04 |